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General NPI Number Information
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NPI Number | 1700785581
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Entity Type | Organization
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Legal Business Name | GRACE RECOVERY SERVICES
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Dates
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Enumeration Date | 11/05/2026
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Last Update Date | 11/05/2026
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Provider Practice Location Address
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Address Line | 1415 MADISON PARK DR
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City | GLEN BURNIE
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State | MD
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Zip | 21061-5866
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Country | US
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Telephone | 410-999-0891
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Fax |
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Provider Business Mailing Address
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Address Line | 1401 MADISON PARK DR STE 100A
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City | GLEN BURNIE
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State | MD
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Zip | 21061-6140
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Country | US
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Telephone | 410-999-0891
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Fax |
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Authorized Official
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Title or Position | COMPLIANCE OFFICER
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Name | TAMI CONWAY
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Credential |
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Telephone | 410-999-0891
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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